White Spots on Gums: Causes, Treatments and How to Prevent

White Spots on Gums

Several conditions can cause white spots to appear on your gums. While some of these conditions are mild and temporary, others are more serious.

Depending on the cause, white spots on your gums may be small and isolated or in clusters, and they may or may not be painful.

With some conditions, white spots on gums are likely to go away on their own. In other cases, they may require medication or other professional treatment.

What Can Cause White Spots on Gums?

Your gums may present with white spots or patches for several reasons. The way the spots look and feel can help determine the underlying cause.

Canker Sores

Canker sores are oral ulcers that often appear as small white or yellow bumps with red, inflamed borders.¹ They generally cause pain during eating, drinking, and brushing.

While canker sores don’t have a clear cause or a definitive cure, they can be affected by your diet. Low levels of iron, selenium, and vitamins D, B9, and B12 may play a role in the development of canker sores.²

Although they can be painful and interfere with daily life, canker sores aren’t associated with any other severe condition. They often resolve on their own within one to three weeks.

It’s estimated that as much as 25% of the general population suffers from recurring canker  sores.¹

Oral Lichen Planus

Oral lichen planus is an autoimmune condition that shows up as irregular patches or blotches with white lacing or webbing. These patches can look like lichens, giving the condition its name.

The white lacy patches may come with no other symptoms, or they may be painful and sensitive to certain foods. Occasionally, the white patches can develop into painful open sores. 

Oral lichen planus may affect your gums as well as your inner lips and cheeks. If it affects your tongue, you may notice changes in your sense of taste.

Lichen planus can also affect other parts of the body, including the skin, esophagus, and genitals.

There are multiple possible causes and contributing factors for lichen planus. It may be triggered by certain medications or allergens, stress, or possibly viruses.³

While not life-threatening in itself, oral lichen planus may be associated with a slightly increased risk of oral cancer.⁴

There isn’t a cure for lichen planus, but there are various medications and treatments that can help manage the symptoms. A corticosteroid may be prescribed to reduce inflammation.

Oral Thrush

Oral thrush, also known as oral candidiasis, is an oral yeast infection caused by Candida albicans or sometimes other Candida yeast species.

Creamy or cottage cheese-like white patches in the mouth or on the tongue are a common symptom of oral thrush. These patches may be accompanied by a burning sensation.

Candida albicans is common in the oral and intestinal flora of healthy people. Normally, your immune system and competition from other organisms keep it in check.^{5, 6}

In cases where the immune system is compromised or Candida’s competitors are eliminated (such as by antibiotics), an infection can result.

Antifungal medications can treat oral thrush effectively. However, in rare, extreme cases, the yeast can enter the bloodstream and cause a potentially fatal systemic infection.⁶

Leukoplakia

Leukoplakia involves thick white or grayish patches that form on the gums and inner lips and cheeks. It can resemble oral lichen planus or oral thrush.^{7, 8}

These white or grayish patches may feel hard and don’t wipe away. But they generally don’t cause pain.

The exact causes of leukoplakia haven’t been determined, but tobacco is a main contributor. Leukoplakia is significantly more common among smokers than nonsmokers.⁸

Long-term alcohol consumption and chronic irritation (such as from foreign objects or poorly fitted dentures) may also contribute to the development of leukoplakia.⁷

Leukoplakia patches are often benign, but can be precancerous in some cases. Speckled leukoplakia, where the patches appear to have a mix of white and red areas, may be a sign of potential cancerous growth.⁷

According to Dr. Nandita Lilly, one of NewMouth’s in-house dentists, “since leukoplakia can be precancerous, it is recommended to have a biopsy performed on the lesion.”

Other Causes

It’s possible for oral cancer to appear as white patches on your gums or mouth lining. Ear pain, loss of sensation, and sudden and unexplained weight loss are also symptoms of oral cancer.

White spots may also appear on your gums due to an injury or because of hormonal changes (such as during pregnancy).

You should see your doctor or dentist if you notice unusual changes in the way your mouth looks or feels.

How to Get Rid of White Spots on Gums

If you have white spots or patches on your gums, the way to get rid of them differs depending on the cause.

In cases of canker sores or oral lichen planus, there is no definitive cure. Canker sores generally resolve on their own, however.

Lichen planus is an autoimmune condition that generally doesn’t go away. Oral lichen planus often recurs even if the patches are removed.

Oral lichen planus can often be managed by reducing mouth irritation (such as from dentures or hard toothbrushes) and improving oral hygiene. You may also be prescribed corticosteroid medication.

Oral thrush, like other yeast infections, is generally treated with antifungal medications.

Leukoplakia goes away in many cases when people stop using tobacco or alcohol. In some cases, a doctor may perform a biopsy and remove the patches with a scalpel or other medical device.

Preventing White Spots on Gums

In general, the main causes of white spots on your gums or mouth lining can be prevented with the following:^{1, 3, 5, 6, 7, 8}

• Good oral hygiene — Regular brushing, flossing, and rinsing keeps harmful bacteria and yeasts such as Candida in check. It also prevents irritating materials from accumulating in your mouth.
• Reducing mouth irritation — Fix any ill-fitting dentures or retainers and avoid putting foreign objects or allergens in your mouth. Also, try using a softer toothbrush.
• Eating a balanced diet — Lowering your intake of simple carbohydrates can help ensure the health and diversity of your oral and gut flora. Adequate vitamin intake is also good for your oral and overall health.
• Avoiding tobacco — Smoking, chewing, and dipping tobacco can all contribute to the development of leukoplakia and oral cancer.
• Reducing stress — Stressful events can’t always be avoided, but they can contribute to inflammation, a weakened immune system, and autoimmune disorders.

Summary

Canker sores, oral lichen planus, an oral yeast infection, and leukoplakia are all possible causes of white spots on gum tissue. White spots may or may not be painful.

These conditions can generally be either managed or eliminated with the right treatment. Talk to a doctor or dentist if you notice any painful, sudden, or unusual changes in the way your mouth looks or feels.